Determining factors of patient satisfaction for frequent users of emergency services in a medical center

Abstract

Background: The present era of a competitive healthcare environment indicates that providers have been convinced that attentiveness to patient satisfaction is integral to care quality and market share. Patient satisfaction is especially critical for frequent users of the emergency department (ED). The aim of this study was to compare satisfaction of overall ED care between frequent and infrequent ED users, and to find out the factors determining satisfaction among the frequent ED users.

Methods: Frequent ED users (> or = 4 visits/per year) and infrequent ED users (< 4 visits/per year) were selected randomly from patients visiting the adult ED of a public tertiary medical center from October 1, 2000 to September 30, 2001. Retrospective telephone interviews were completed for 200 frequent users and 200 infrequent users. Ordinal logistic regression analysis was performed.

Results: Infrequent ED users tended to give a higher satisfaction rating than frequent ED users to emergency care (OR = 2.14; 95% CI = 1.40-3.25). The 2 significant determinants associated with satisfaction with emergency care among frequent ED users were discharge instructions (OR = 2.78; 95% CI = 1.27-6.12) and subjective waiting time (OR = 12.6; 95% CI = 4.22-37.8).

Conclusions: The frequent ED users were unique, and their satisfaction with overall emergency care was significantly lower than that of infrequent ED users. Managing waiting time perceptions and providing discharge instructions may be an effective strategy to achieve improved patient satisfaction among frequent ED users.